Page 20 Telehealth and Remote Patient Monitoring RPM for Long Termand Post Acute Care A Primer and Provider Selection Guide 2013

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that will be used to evaluate the performance of the ing home services, and limit the need for patients
Centers for Medicare & Medicaid Services (CMS) to be transported. Another study by researchers at
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Shared Savings ACO program. the University of Virginia Health System found that
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telehealth interventions in a long-term care com-
munity setting replaced patient transport to a local
5.5 Caregivers’ Workload and wound care clinic. Furthermore, some research in-
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Efficiencies dicates there may also be a decreased need or desire
to travel outside the local community for health
Increasing access to health care through telehealth care services in communities where telehealth ser-
and RPM, especially to patients living in rural areas, vices are offered. 40
has the potential to reduce health care costs and
improve efficiencies in a variety of ways includ- Operational efficiency is another important con-
ing decreasing the number of nurse home care sideration. Many telehealth and RPM solutions
visits, reducing the number of patient transports operate at very low levels of efficiency because of
to hospitals and physician offices, and increasing time consuming set-up and inefficient software
access to specialists such as wound care experts or solutions. A low level of efficiency is very difficult
pulmonologists. One study, for example, found that and costly to scale to large populations. Staffing is
a telehealth intervention utilized by a home health often times one of the greatest expenses to an orga-
agency reduced the number of home visits by nization and ensuring that the telehealth and RPM
nurses from 8.2 to 5.8 per month. Another study solution maximizes operational efficiency while
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found that one out of every four in-person visits maintaining efficacy is a key area to consider.
can be avoided with telehealth store-and-forward
technology. And, one out of every two clinic visits
can be avoided with real-time consults. Finally, a 5.6 Reduced Risk and Liability
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recent study published in Health Affairs found that Telehealth and RPM, as well as other monitoring
telehealth and RPM can increase care provider’s technologies, provide a means for detecting aris-
productivity by decreasing home visit travel time ing health issues that would go undetected without
and utilizing automated documentation systems. 37 the technology. Hence, they have the potential to

Efficiencies can also be found in reducing patient reduce risks and providers’ liability as they gener-
transportation costs and increasing access to spe- ate documentation of events, signs, symptoms and
cialists via telehealth technologies. Remote visits interventions. This is especially true when the use
to patients in skilled nursing facilities for wound of these technologies is coupled with policies and
care, for example, can result in avoided transporta- procedures about response protocols and respon-
tion costs. In a review of 53 geriatric applications sibilities, clear delineations of responsibilities in
of telehealth, Jennett and colleagues found that contractual and service agreements, and documen-
telephone consultations to geriatric patients and tation of interventions/actions taken, by whom and
video consultations related to chronic wounds can when. 41
be cost-saving because they reduce the use of nurs-

Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013